{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:14:41Z","timestamp":1791810881469,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>To determine early continence outcomes after three\u2010layer vesicourethral reconstruction during robot\u2010assisted radical prostatectomy (RARP) and the role of postoperative cystography pattern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between May 2015 and January 2019, a total of 170 consecutive patients with localized prostate cancer who underwent RARP, were divided into one\u2010 and three\u2010layer groups based on the method of vesicourethral reconstruction. Continent status, preoperative, intraoperative, postoperative, clinicopathological variables, and cystography parameters were analyzed. The patients were followed up for at least 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 170 consecutive patients, 85 with one\u2010layer vesicourethral anastomosis, and 85 with three\u2010layer reconstruction. The continence rates immediately after catheter removal, 4, 12, and 24 weeks after RARP were 47.1%, 75.3%, 92.9%, and 98.8% in the three\u2010layer group; compared to 15.3%, 60%, 78.8%, and 90.6% in the one\u2010layer group, respectively. In the multivariate analysis, three\u2010layer reconstruction was the only independent variable with a 42% risk reduction of postprostatectomy incontinence (hazard ratio (HR): 0.58, 95% confidence interval (CI)\u2009=\u20090.42\u20130.80, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Cystography in the three\u2010layer group revealed less anastomotic leakage, less sharp bladder neck angle, and higher bladder neck level category.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Three\u2010layer anatomical reconstruction demonstrated promising early continence outcomes, and postoperative cystography revealed a specific pattern more associated with continence.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27636","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T08:30:09Z","timestamp":1712910609000},"page":"1332-1340","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Modified three\u2010layer vesicourethral reconstruction in robot\u2010assisted radical prostatectomy can change cystography pattern and improve early recovery of continence"],"prefix":"10.1002","volume":"129","author":[{"given":"Hung\u2010Yi","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology Chang Gung Memorial Hospital at Keelung Keelung Taiwan"},{"name":"College of Medicine Chang Gung University Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jui\u2010Ming","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology Taoyuan General Hospital, Ministry of Health and Welfare Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4832-0113","authenticated-orcid":false,"given":"I\u2010Hung","family":"Shao","sequence":"additional","affiliation":[{"name":"College of Medicine Chang Gung University Taoyuan Taiwan"},{"name":"Department of Urology Chang Gung Memorial Hospital at Linkou Taoyuan 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